Andrade Z A
Centro de Pesquisas Gonçalo Moniz, Fiocruz, Salvador, Ba, Brasil.
Mem Inst Oswaldo Cruz. 1992;87 Suppl 4:129-38. doi: 10.1590/s0074-02761992000800019.
Optical and electron microscopical evidences of focal matrix degradation were frequently seen in liver sections taken from patients with periportal ("pipe-stem") fibrosis caused by schistosomiasis mansoni. Besides the presence of focal areas of rarefaction, fragmentation and dispersion of collagen fibers, the enlarged portal spaces also showed hyperplasia of elastic tissue and disarray of smooth muscle fibers following the destruction of portal vein branches. Ultrastructural changes represented by focal lytic and/or electron dense alterations of collagen fibrils were similar to those first seen in experimental material and designated as "chronic collagen degradation". Elastin and related microfibrils were also affected by focal condensation, fragmentation, distortion and dissolution. Schistosome eggs were scanty in the tissue sections examined. Matrix degradation represented involuting changes related to the progressive diminution of parasite aggression, which occurs spontaneously with age or after cure by chemotherapy. Changes of focal matrix degradation now being described represent the basic morphological counterpart of periportal fibrosis involution documented clinically, especially by ultrasonography, in patients with hepatosplenic schistosomiasis submitted to curative chemotherapy.
在取自曼氏血吸虫病引起的门周（“干线型”）纤维化患者的肝脏切片中，经常可见局灶性基质降解的光学和电子显微镜证据。除了存在胶原纤维稀疏、断裂和分散的局灶区域外，扩大的门管区还显示弹性组织增生以及门静脉分支破坏后平滑肌纤维排列紊乱。以胶原原纤维局灶性溶解和/或电子密度改变为特征的超微结构变化与首次在实验材料中观察到的变化相似，被称为“慢性胶原降解”。弹性蛋白和相关微原纤维也受到局灶性凝聚、断裂、扭曲和溶解的影响。在所检查的组织切片中，血吸虫卵很少见。基质降解代表与寄生虫侵袭逐渐减少相关的退化性变化，这种变化会随着年龄增长或化疗治愈后自发发生。目前所描述的局灶性基质降解变化代表了肝脾血吸虫病患者接受根治性化疗后临床上记录的门周纤维化退化的基本形态学对应物，尤其是通过超声检查记录的。
